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目的:评价hMAM和CK19 mR-NA联合检测早期乳腺癌循环肿瘤细胞的临床价值。方法:采用RT-PCR检测早期乳腺癌患者CK19、hMAM mRNA阳性循环肿瘤细胞。结果:hMAM和CK19 mR-NA联合检测早期乳腺癌患者循环肿瘤细胞阳性率(52.0%)均高于良性乳腺疾病患者(16.7%)和健康体检者(5.0%),P值分别为0.004和0.000;阳性率与癌组织HER-2过表达相关,P=0.049。联合检测的敏感度为57.5%,特异度为88.6%。26例联合检测阳性患者,13例随访期出现转移复发,P=0.001;中位无瘤生存期明显降低,P=0.000。结论:hMAM和CK19mRNA是一组敏感度和特异度较好的诊断早期乳腺癌患者循环肿瘤细胞的基因标志,可能作为早期乳腺癌术后监测转移复发辅助指标。
Objective: To evaluate the clinical value of hMAM and CK19 mR-NA combined detection of circulating tumor cells in early stage of breast cancer. Methods: CK19 and hMAM mRNA positive circulating tumor cells were detected by RT-PCR in early breast cancer patients. Results: The positive rate of circulating tumor cells in patients with early breast cancer detected by hMAM and CK19 mR-NA was higher than that of patients with benign breast disease (16.7%) and healthy subjects (5.0%), the P values were 0.004 and 0.000 ; The positive rate was correlated with the overexpression of HER-2 in cancer tissues, P = 0.049. The sensitivity of combined detection was 57.5% and the specificity was 88.6%. Twenty-six patients were positive for combined detection, with metastasis and recurrence in 13 cases (P = 0.001). The median tumor-free survival time was significantly lower (P = 0.000). Conclusion: hMAM and CK19 mRNA are a set of sensitive and specific diagnostic markers of circulating tumor cells in patients with early stage breast cancer, which may be used as an auxiliary index to monitor postoperative metastasis and recurrence of early stage breast cancer.